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Biochemistry > Blood Coagulation and Wound Healing Pt. 2 > Flashcards

Blood Coagulation and Wound Healing Pt. 2 Flashcards

(72 cards)

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1
Q

What is the source of the growth factor TNF-alpha?

A

macrophages, T-lymphocytes

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2
Q

What is the source of the growth factor TGF-alpha?

A

activates macrophages, platelets, epithelial cells, injured cells

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3
Q

_____ are found during the inflammatory phase.

A

macrophages, neutrophils

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4
Q

Can disease states interfere with wound healing and progression?

A

absolutely (diabetes, venous/arterial disease, old age, infection)

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5
Q

The ____ takes citrated plasma and then adds calcium and thromboplastin to the test tube to evaluate the presence of clotting factors in the blood sample.

A

prothrombin test

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6
Q

What is ACD anticoagulant?

A

Acid Citrate Dextrose Solution is a solution of citric acid, sodium citrate, and dextrose in water

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7
Q

Drugs that prevent blood coagulation are:

A

Warfarin, Pradaxa, Xarelto, Eliquis, Plavix

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8
Q

Does plasma contain clotting factors?

A

YES

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9
Q

What is the source of the growth factor IL-1?

A

macrophages

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10
Q

What are the functions of IL-1?

A

fibroblast proliferation

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11
Q

Patients with a _____ deficiency (Glanzmann’s thrombasthenia) may experience hematoma, prolonged or excessive bleeding, nosebleeds, and petechiae.

A

GPIIb/IIIa

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12
Q

What is the source of the growth factor EGF?

A

plasma, platelets, macrophages, epithelial cells

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13
Q

Which growth factors inhibit fibroblast proliferation?

A

IFNs

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14
Q

The prothrombin time is a measure of the integrity of the _______ and ______ pathways of the coagulation cascade.

A

extrinsic; common

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15
Q

What is the source of the growth factor IFNs?

A

lymphocytes, fibroblasts

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16
Q

What are the functions of IGF-1?

A

synthesis of sulfated proteoglycans and collagen, fibroblast proliferation

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17
Q

_____ are found during the remodeling phase.

A

collagen fibers

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18
Q

What does the prothrombin test evaluate the presence of?

A

prothrombin (II), fibrinogen, factors X, V, and VII (components of the extrinsic and common pathway)

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19
Q

What are the functions of EGF?

A

epithelial cell proliferation, granulation tissue formation

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20
Q

Which growth factors induce fibroblast proliferation?

A

PDGF, TGF-beta, IL-1, FGF, TNF-alpha, IGF-1

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21
Q

When the INR is higher than the recommended range, it means your blood clots ____, and a lower INR means your blood clots ____.

A

slowly; quickly

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22
Q

Which blood thinning drugs have rapid onset and rapid wear off?

A

Pradaxa, Xarelto, Eliquis

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23
Q

What are the functions of TGF-beta?

A

induces fibroblast proliferation, chemotaxis, collagen metabolism

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24
Q

How important is it that these wound healing steps are made in a sequential order?

A

VERY important

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25
How does Warfarin reduce the synthesis of active clotting factors and induce blood thinning?
by depleting the functional vitamin K reserves
26
Patients with a _____ deficiency (Bernard Soulier) may have increased nosebleeds, spontaneous bleeding, petechiae and heavy periods.
GPIb
27
What are the functions of TNF-alpha?
fibroblast proliferation
28
The extrinsic pathway can compensate for the impaired intrinsic coagulation pathway seen in patients with a _____ mutation because either pathway can activate the needed proteins.
kallikrein
29
What are the functions of KGF?
epithelial cell proliferation
30
_____ are found during the proliferation phase.
fibroblasts, myofibroblasts, granulation tissue, keratinocytes, endothelial cells
31
What happens during the inflammatory phase?
bacteria and debris are phagocytosed by WBCs; factors are released that cause migration and division of cells
32
What happens during the remodeling phase?
collagen is remodeled along along tension force lines and some cells are removed via apoptosis
33
_____ syndrome isa bleeding disorder caused by defective scrambling of membrane phospholipids such as the exposure of phosphatidylserine (PS) on the outer surface.
Scott
34
How does ACD work?
citrate disrupts the coagulation cascade by binding the citrate compounds to the calcium in the blood; reducing calcium in the blood inhibits the start and regulation of the clotting cascade
35
Hemophilia is an _____ disease.
X-linked recessive
36
Why would someone get a prothrombin test?
it is often used for people who take blood thinning medications
37
What is the source of the growth factor PDGF?
platelets, macrophages, endothelial cells, injured cells
38
What are the functions of FGF?
fibroblast proliferation, matrix deposition, wound contraction angiogenesis
39
A mutation in the ____ gene causes bleeding of the gums and blood in the urine. It can cause factor X deficiency (type I) or impair factor X protein function (type II).
F10
40
If the INR is greater than 5, the person ___ clot.
cannot
41
How could a clinical neutralize the effects of Warfarin?
by administering a massive dose of vitamin K to the patient
42
What is the source of the growth factor IGF-1?
plasma, liver, fibroblasts
43
Why is the Internationalized Normalized Ratio (INR) used for the prothrombin test?
because the reagents used are different for each lab and change over time
44
What are the functions of PDGF?
induces chemotaxis, fibroblast proliferation, collagenase production
45
A decrease in the blood concentration of calcium will ____ the clotting cascade.
halt
46
Which blood thinning drug requires frequent monitoring?
Warfarin
47
_____ induce the sequential phases of wound healing.
Released growth factors
48
A _____ is a test used to help detect and diagnose a bleeding disorder or excessive clotting disorder.
prothrombin time (PT)
49
Why does Warfarin have interactions with food?
because the amount of vitamin K in the diet can have an effect on the INR
50
The mutation of factor ____ leads to an overproduction of prothrombin, which leads to more thrombin, which promotes the formation of blood clots.
II
51
What is the source of the growth factor TGF-beta?
macrophages, platelets, neutrophils, lymphocytes, fibroblasts, epithelial and endothelial cells, injured cells
52
The most common mutation in people with severe hemophilia A is a rearrangement of genetic material called ______.
inversion
53
What are the functions of IFNs?
inhibition of fibroblast proliferation and collagen synthesis
54
An INR of ___ or below is considered normal.
1.1
55
How does the drug Pradaxa work?
It is a direct thrombin inhibitor (IIa)
56
_____ are found during the hemostatic phase.
red blood cells, platelets
57
What part of the clotting cascade do the drugs Xarelto and Eliquis inhibit?
Factor Xa
58
Does serum contain clotting factors?
NO
59
Hemophilia ___ is the decreased synthesis of factor IX (9) and is treated with recombinant factor IX.
B
60
What is the source of the growth factor KGF?
fibroblasts
61
Why does depleting the vitamin K reserves prevent blood clotting?
because the synthesis of coagulation factors II, VII, IX, and X, as well as protein C and S require the presence of vitamin K to function (Vitamin K is an ESSENTIAL cofactor)
62
S-warfarin is the most active isomer of warfarin. How does it control the production of vitamin K?
by inhibiting vitamin K reductase, thereby preventing the reduction and activation of oxidized vitamin K
63
What happens during the proliferative phase?
angiogenesis, collagen deposition, granulation tissue formation, epithelialization, wound contraction
64
The stem cell niche, where the classic model of would healing begins, is located in the ______.
bone marrow
65
A shortage of coagulation factor VII can be caused by a mutation of the F7 gene and can cause episodes of ____ bleeding.
abnormal
66
Even though both are clot busters, TPA works ____ in the blood, while plasmin works ____.
systemically; locally/regionally
67
What is the classic model of wound healing?
hemostasis > inflammatory > proliferative > remodeling
68
Warfarin competitively inhibits the _______ complex, which is an essential enzyme for activating the ____ available in the body.
vitamin K epoxide reductase (VKORC1); vitamin K
69
What happens during the hemostasis/coagulation phase?
platelets aggregate at the injury site and prompt the formation of a fibrin clot
70
Hemophilia ___ is the decreased synthesis of factor VIII (8) and is treated with recombinant factor VIII.
A ("A"ight)
71
What is the source of the growth factor FGF?
pituitary, macrophages, fibroblasts, endothelial cells
72
What are the functions of TGF-alpha?
epithelial cell proliferation, granulation tissue formation

Biochemistry (17 decks)

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